Some people lose balance due to Parkinsons MS, cerebral palsy, peripheral neuropathy, a cerebrovascular accident (CVA), or some other neurological condition. Other people may have balance concerns that they incorrectly attribute to a normal consequence of the aging. Physical Therapists are trained to examine the multifaceted causes of balance deficiencies, and design a treatment program to reduce a person’s risk of falling.
During the examination process, your physical therapist conducts an assessment of musculoskeletal causes of poor balance. These include ROM/flexibility, muscle strength, and muscle tone. Good flexibility is essential as all muscles have an optimal length to work effectively to maintain balance. Muscle strength plays a role as well; muscles must contract in a controlled manner to correct for a loss of balance. Muscle tone can be an issue with those with neurological conditions as the damaged central nervous system may have a tendency to over or under utilize the correct muscles.
The physical therapist also takes into account sensory systems related to balance including the visual system, somatosensory system, and the vestibular system. Many people are “visually dependent” which means they use vision to adjust to changes that may upset their balance. The somatosensory system refers to neurological “receptors” in joints and muscles that, among other things, detect the position of body parts in space. The vestibular system refers to the sensory organs within the inner ear that are particularly important to balance when vision and somatosensation are unreliable, such as in a dark room or on a moving surface.
After a detailed balance assessment, which will also include functional tests to assess overall fall risk, your physical therapist is able to tailor an individualized treatment program to address the specific needs of each patient based on the findings of your examination. This will often involve therapeutic exercises to improve strength and flexibility as needed, and working with the appropriate sensory systems for improvement or adaptation.
From pediatrics to geriatrics, the skilled physical therapy staff at Mary Lou Corcoran treats patients from all phases of life. If you are suffering from balance difficulties, you may want to consider asking your physician for a prescription for physical therapy and make an appointment for an evaluation, the first step on your way to feeling more confident and steady on your feet.
Sources:
Motor Control: Theory and Practical Applications, 2nd ed. Shumway-Cook and Woollacott; Williams and Wilkins, 2001.
Mosby’s Medical, Nursing, & Allied Health Dictionary, 6th ed. Mosby 2002.
Course notes and handouts from “Assessment and Treatment of Balance Dysfunction: Systems-Based Task Oriented Approach,” presented by Jan Coy M.A., PT, September 15, 2003.
Posted by SHERRY MOSER, MPT
